Question
Should my partner start treatment taking Sustiva and Truvada separately?
20 December 2008. Related: All topics, Drug interactions, Side effects, Starting treatment.
My partner has been on Sustiva (efavirenz) and Truvada (tenofovir + FTC) for a fortnight and is doing good(touch wood).
I am very proud of him and just HOPE that this treatment is working for him:) He has been prescribed Truvada at 10am and then Sustiva at 10pm. Is this dosing right?
I have read elsewhere that people normally take these two drugs together of a nighttime. Is his regimen as potent or will it fail because of the times of the doses?
Many thanks for all your help and happy christmas to you all, you are doing an absolutely AMAZING job and thank you for being there for people like myself.I am amazed at what medicine can do and how important it is. many thanks
Answer
Until your partners viral load gets to undetectable, it is probably better for him to separate the doses so he can take Truvada with breakfast and efavirenz at night a couple of hours after dinner. If it is more convenient, he could take the Truvada at night with dinner.
This is the advice given in Europe.
This is because food increases tenofovir levels (a good thing) and a high fat meal would increase efavirenz levels (not a good thing).
After he is undetectable, he can take them all together at night, and even switch to Atripla, which is one pill containing all these drugs.
See this recent question on dosing, timing and the food effect with Truvada, which explains why this advice is different in Europe to the USA.
I’m sorry this is so complicated. However, it is very likely that your boyfriend will do really well so long as he doesn’t miss doses – whichever advice and regimen he follows.
Have a nice xmas too.
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